Sunday, June 17, 2012

Weekly Australian Health IT Links – 18th June, 2012.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

As we run down to what will be the biggest ‘non-launch’ in history we are now seeing all the nonsense that has gone on in the last two years being exposed. I suspect we are going to see a run of such ‘confessions’ as to delivery failure over the next little while.

For the present there is little else to highlight but, of course, there are always a few interesting things to browse. Certainly what is happening ‘across the ditch’ makes for very interesting and rather frustrating reading given our relative lack of progress in OZ.

IBM is being pushed to deliver the National Authentication Service for Health in time for the Gillard government's $1 billion personally controlled e-health record system's July 1 launch.

The NASH service should be delivered on June 26, the National E-Health Transition Authority's PCEHR project head, Andrew Howard, has told an industry webinar.

"I'll stress that (IBM has) a contractual obligation to deliver a functional authentication solution at a national level to support the PCEHR and other health sector requirements by June 26," Mr Howard said.

"IBM (has told us) they are continuing to meet that schedule."

The NASH is a key part of the PCEHR system, as it will verify authorised users and support secure communications among medical providers.

TWO weeks before the introduction of the Gillard government's $1 billion e-Health scheme not one medical practice has signed up to use it, forcing Canberra to back down on a move to compel doctors to accept full liability for problems with the initiative.

The Department of Health and Ageing this week agreed to remove contentious contract conditions that would have made doctors liable if one of their employees leaked information contained in a patient's electronic health record.

It has also amended a clause that would have allowed government officials to raid surgeries and remove computers and records when a breach of the e-Health system was being investigated.

The Federal government has agreed to revise the PCEHR terms and conditions to remove a clause that would have made doctors liable for data breaches.

Following a meeting between medical indeminity providers and the Department of Health and Ageing, it was also agreed to amend a clause that would have allowed practices to be raided by government officials to remove computers and records if a data breach was suspected, according to The Australian.

TASMANIA's e-health records rollout has received a $37 million boost as part of a $325m "emergency rescue package" for the state's "ailing health system" announced by federal Health Minister Tanya Plibersek today.

The e-health allocation will fund the state's rollout of the personally controlled e-health record to state hospitals, and "enable allied health, pathology and diagnostic imaging services to connect" to e-health services.

With the $37m investment for the Tasmanian rollout, recent e-health budget commitments worth $224m and a further $50m to help Medicare Locals with system training and connectivity, the amount committed to the PCEHR program is now $1.1 billion - more than double the originally budgeted $467m.

THE Gillard government's $1.1 billion e-health records program will launch without the key user verification system in place, with the National E-Health Transition Authority (NEHTA) conceding it has failed to deliver the project on time.

NEHTA chief executive Peter Fleming confirmed that the National Authentication Service for Health (NASH), being built by IBM under a $23.6 million contract project-managed by NEHTA, would not be ready for July 1.

The Australian reported last week that IBM was being pressed to complete the build by June 26 - just days before the due launch date.

The Department of Health and Ageing has agreed to scrap controversial contract conditions that would have made GPs liable if someone in their practice hacked into a patient’s electronic health record.

Medical indemnity insurers met with government officials on Tuesday to try to resolve a dispute over a draft of the contract that GPs will have to sign to participate in the personally controlled electronic health record system (PCEHR).

Medical indemnity insurers are meeting with government officials Tuesday to try to resolve a stand-off that threatens to derail the national e-health system.

Under draft conditions labelled “absurd” by MDA National, the Federal Government would require GPs participating in the personally controlled electronic health record system to sign a contract agreeing the government is not liable for breaches of patients records.

Associate Professor Julian Rait, president MDA National, told Australian Doctor last week: ”The contract doctors have to sign will put the legal liability on the GP. Unless the government is prepared to accept its reasonable liability ; we will be advising members not to participate.”

MDOs and GP organisations have refused to endorse the national e-health record system less than a month from the launch date, amid concerns it will lead to a spike in complaints and the cost of medical insurance.

MO understands that despite almost three months of negotiation, the health department, AMA, RACGP and medical insurers have yet to reach agreement on the extent to which practices should be liable for claims arising from use of the system.

Further meetings have been scheduled this week in an effort to break the deadlock in time for practices to sign up before the system goes live on 1 July.

A department spokesperson said the patient consent form is expected to go to print soon but said consultations on a range of issues were “ongoing”.

The CareConnect eReferrals initiative is in the throes of revolutionising the primary-secondary care interface. As of today it is installed on 185 Auckland general practices (that’s over half of Auckland’s general practices) and we are currently installing at the rate of five practices a day. Five thousand CareConnect eReferrals have now been sent and that number is climbing sharply.

Using CareConnect eReferrals, referrers can send 24 different customised referral forms to 36 services across three district health boards: Auckland, Waitemata and Counties Manukau. The CareConnect system automatically detects which DHB the patient should go to, based on the patient’s home address (NHI) and where that particular service is available. When fully deployed and integrated with the DHBs’ patient management systems, the CareConnect solution will be without doubt the most advanced, standards-based eReferral system in the world.

MEDICAL and fitness experts are worried about increasing reliance on smartphone and tablet apps for health and fitness advice, in the same way many people rely on a ''Google diagnosis'' for health problems.

A senior medical negligence lawyer said app creators and distributors could be sued if something goes wrong - in the same way as manufacturers and distributors of drugs or medical devices.

While many apps in medical, health and fitness categories appear to work well, experts are concerned that some do not take personal circumstances into account and could be misused.

Sports Medicine Australia's Queensland branch executive officer, Mark Brown, said it was worrying to see an increasing reliance on apps and the internet to guide diagnosis of conditions and how to exercise.

This is the second of a series of posts dealing with representing pathology reports in NEHTA Discharge summaries. The first post dealt with the transforming the TX format into CDA. This post deals with the PIT format. Follow up posts will deal with the FT format, and then with the general context of representing pathology reports in clinical documents.

The PIT format is an old format for sending pathology reports to the requesting doctor. It’s throughly outdated, everybody dislikes it, and no one is supposed to send it anymore. So, of course, you run into it all over the place. The documentation can be found here.

This is the 3rd post in a series focusing on the representation of pathology reports in NEHTA clinical documents. The context of this work is that a clinical system is assembling a clinical document for some kind of summary report – a discharge summary, an event summary, or a referral – and document will include a set of pathology reports.

The context doesn’t include a clinical user quoting from a pathology report by copying and pasting into a clinical document, but where the system is assembling the document (usually following some human guidance). Also, the context of this is not for a lab generating the original reports – this is only about reuse for those systems that wish to do so. Finally, a note for my US readers: here in Australia, “Pathology” includes all clinical lab disciplines, not the narrower usage it has in USA.

The success of the PCEHR in the aged care sector depends heavily on getting service and facility providers aboard, according to the national Aged Care IT Council (ACIITC) chair, Suri Ramanathan. Mr Ramanathan is closely involved in the recently announced NEHTA aged care software vendor panel.

Speaking with eHealthspace.org, Mr Ramanathan explained that NEHTA’s establishment of the vendor panel was a recognition of the importance of their role in a like manner to the panels already in operation for other key groups such as general practice and pharmacy.-----

The National E-Health Transition Authority (NEHTA) announced last week it had executed contracts with five aged care software makers to form a vendor panel that will support and encourage the introduction of personally controlled electronic health records (PCEHR) across the sector.

A REPORT has called for a 10-year federal funding commitment for Medicare Locals to overcome primary health care’s “deep uncertainty” about the future of the reform.

The report by the Australian Health Care Reform Alliance (AHCRA) – a lobby group representing a number of allied health and consumer groups – also said the federal government must give a “clearer shared vision” about primary health care, backed up by changes to ML funding.

The report, based on interviews with ML staff during the early stages of the new reform, was released yesterday just weeks after Opposition health spokesman Peter Dutton surprised ML leaders by indicating he would discontinue the rollout if the Coalition took office. Polls generally suggest the Coalition would win the next election due by late 2013, more than a year after the last general practice division hands its work to an ML.

A Victorian government report into its spending of hundreds of millions of dollars for technology services has revealed deep flaws that resulted in shelf companies with self-written evaluations being accepted onto supplier panels.

Victorian Technology Minister Gordon Rich-Phillips will on Tuesday tell the industry that the controversial eServices supplier panel will be scrapped and replaced by an open ­registry of tech companies.

The eServices Government and Industry Working Party report comes after several technology ­mishaps for the Victorian government.

Earlier this year several investigations were launched into its technology agency CenITex amid allegations it awarded a contract to itself and paid some contractors more than $1000 a day.

Gary Cohen, the founder and former executive chairman of iSOFT, is plotting a return to Australia’s listed information technology sector by derailing the sale of digital services player Hyro.

Shareholders in the struggling Hyro are due to meet on Friday afternoonto vote on a $17.2 million takeover offer from Nasdaq-listed Kit Digital that values it at nearly twice its market capitalisation. The cash and scrip bid has been marred by a 40 per cent drop in Kit Digital shares since the offer was announced on April 23, but the offer has a $13 million floor.

High profile technology entrepreneur Gary Cohen has narrowly failed in his bid to derail the sale of ASX-listed digital services player Hyro, after shareholders voted to accept an offer from Nasdaq-listed Kit Digital on Friday afternoon.

Mr Cohen, the co-founder of recently sold health technology company iSOFT, had tabled an alternative proposal to shareholders, which would have seen him inject cash, take over the running of the company as executive chairman, and acquiring a growing social media business business to roll into Hyro.

Tonight, at 10pm Australian EST, the Internet Corporation for Assigned Names and Numbers (ICANN) will unveil the list of applications for new top-level domains (TLDs), which will allow organisations to register 'dot word' domains along the lines of .bank and .web.

Ruscoe, part of Perth physiotherapist practice Risely Physiotherapy, says that he had the idea for the domain after reading a newspaper article on TLDs in July last year. "I thought, 'I'd like to have one of them for my practice,'" he says.

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